Blackwell Family
Elizabeth Blackwell

From MacKenzie, MorellTelegraph Address
"Phoniatros London"

19, Harley Street,
Cavendish Square, W.
Decr. 3 1889

Dear Madam,

I do not consider 
that the removal of the
whole thyroid gland is
a justifiable operation
but the removal of a
part might sometimes
be undertaken with advantage
especially in cases of
fibroid goitre.  In cystic
or in fibro-cystic disease
the desired end can be
attained very often by
milder treatment such
as puncture, injection
etc.  Whilst the latter
method is almost free
from danger the removal
of a portion of the thyroid
always involves some
risk.

I remain
yours very faithfully,
Morell MacKenzie